Steps to Wellness: Oncology & Hematology Rehabilitation at the University of Vermont Medical Center and the Vermont Cancer Center

You might think that reaching the end of treatment for cancer is a reason to celebrate. Yet, many cancer survivors are confused about their next steps. Survivors often experience fatigue and weakness. They are less fit. They may have trouble doing normal activities. However, more and more research shows that cancer survivors who are physically active have improved survival and a better quality of life. Up till now, there has been no consistent rehabilitation program for cancer survivors.

That’s why we filled the gap with Steps to Wellness, our Oncology and Hematology Rehabilitation Program launched in August 2011. More than 200 cancer survivors have benefited. It’s a free 12-week, twice weekly, individualized exercise program that includes resistance training and aerobic activity. Survivors receive a physical therapist and a medical provider evaluation as part of the program.

The physical therapist evaluates function and identifies any physical deficits of the cancer survivors such as range of motion problems or deconditioning.

The medical provider evaluates for the presence of late/long term effects of cancer therapy such as fatigue, cognitive changes and pain.

If no additional services are needed, survivors will begin the Steps to Wellness exercise program. Two exercise technicians provide training and monitoring and answer exercise-related questions. Education and lifestyle classes are also available. These classes focus on lifestyle, weight loss, and dealing with the late and long-term effects of cancer therapy. During the program, cancer survivors improve their strength and fitness. They also appear to have less depression, anxiety, and fatigue.

Unlike cardiac rehab, these services are not paid for by insurance. To pay for the exercise technicians’ salary and equipment, many supportive individuals donate funding. We are also indebted to the cardiac rehabilitation team – Phil Ades, MD, and his staff – for allowing us to use the UVM Medical Center’s cardiac rehabilitation space on Tilley Drive in South Burlington, Vermont.

Our goal is to continue to expand oncology rehabilitation by providing services to more cancer survivors and by collecting the data we need to justify insurance coverage for these services in the future. For now we depend on support from grateful donors to keep the program going.

From left to right: Kim Dittus, MD, Ph.D., is a hematologist and oncologist at the UVM Medical Center. Patricia O’Brien, MD, is an internal medicine physician at the UVM Medical Center. Susan Lakoski, MD, is a cardiologist at the UVM Medical Center. All three teach in the Larner College of Medicine at UVM. They are affiliated with the Vermont Cancer Center at UVM.

The University of Vermont Medical Center serves all of Vermont and the northern New York region. Located in Burlington, The UVM Medical Center is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont